Cardboard dural retractor for drilling of the sphenoid wing in the pterional approach.
ABSTRACT In the pterional approach, adequate removal of the sphenoid wing is essential. For safe drilling of the medial part, the dura beside the wing is usually retracted with a metal instrument and damage to the instrument may occur. We developed an alternative retraction method that uses a cardboard shield.
Before drilling the medial part of the sphenoid wing, a cardboard shield featuring a notch and a bend in its center is prepared. The notch is inserted between the wing to be drilled and the dura.
The shield retracted the dura beside the wing effectively and provided sufficient space for the diamond drill bit. It held up to the drilling and protected the dura.
This simple method provides a safe adequate operative field without involving additional instruments or expenditures.
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ABSTRACT: Metallic artifacts in magnetic resonance (MR) imaging occur mostly in patients who have received an implant at surgery. Similar artifacts are now increasingly recognized in patients in whom high-speed drills have been used. A 15-year-old male with neurofibromatosis 2 had undergone excision of acoustic neurofibroma on the left 1.5 years prior to the present admission. MR imaging to evaluate the acoustic neurofibroma on the right showed a metallic artifact at the site of the previous surgery. Computed tomography did not show any evidence of metal debris. The artifact was probably caused by metallic dust or debris from a high-speed drill during the first surgery. We suggest that care should be taken to prevent deposition of such debris in the operative field to prevent this complication.Neurologia medico-chirurgica 01/2000; 39(13):938-40. DOI:10.2176/nmc.39.938 · 0.65 Impact Factor